Grab Some Zzzs

By David Spero | November 7, 2007 11:21 am

Do you have trouble sleeping? I do sometimes. Sometimes it’s hard to get to sleep because I’m too wound up. Other times, I drop right off, but wake up several times a night to pee, and then have trouble getting back to sleep.

I don’t have diabetes, but people with diabetes tend to have more trouble than most in sleeping. Some have sleep apnea[1], a condition where you stop breathing for a few seconds until you wake up. Sleep apnea most often occurs in heavy snorers, smokers, overweight people, and people who sleep on their backs. People with sleep apnea may not be aware they’re waking up in the night. They may just feel tired in the morning and all through the next day. Sleep apnea is a major risk factor for stroke[2] and heart disease, so if you suspect you have it, ask your health-care provider to arrange for you to get checked out in a sleep lab.

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Blood glucose levels that are too high or too low can also interfere with sleep, as can certain medicines, especially antidepressants[3] and high blood pressure drugs[4]. Anxiety, depression, and chronic pain are all more common in people with diabetes, and all can keep us awake at night, too.

Insomnia is a major drag on quality of life[5], and it interferes with daytime functioning. So it’s worth treating.

How to Sleep Better Medicines don’t do much good for sleep—we tend to develop a tolerance for them. They can also cause falls[6] when you get up at night, groggy from sleeping pills (although some experts disagree on the dangers of sleep meds). And sometimes they leave you feeling so tired you may as well have not slept at all. It’s OK to take a sleeping pill on a rare special occasion, but it’s not necessarily a good idea to take them regularly.

There are many things we can do, though. Your daytime activity has a lot to do with your nighttime sleep. Physical exercise and sunshine help you sleep by stimulating the body’s melatonin production. The melatonin doesn’t get released into the blood until night falls, but you need sunlight[7] to have it ready. If you just can’t get any exercise or sunshine, ask your doctor about trying melatonin supplements[8]. They don’t make you groggy the way sleeping pills do.

Avoid caffeine after dinner, and avoid extra fluids in the evening—they’ll have you up going to the bathroom all night. Set your room up for sleep—as little light and noise as possible, and a nice comfortable bed to lie on. Consider a new mattress or comfortable pillows.

Develop a bedtime ritual,[9] a set of relaxing things you do every night to signal your body, “time to turn off now.” Rituals can include prayer[10], meditation[11], stretching, a light snack, turning off all the lights in the house, a warm hug, or a backrub. Tell yourself, “I’ve done all I can for today. Whatever is left over, I’ll get to tomorrow. Now it’s time to rest.”

If you can’t get to sleep, don’t lie there tossing and turning. Get up and do something, then come back and try again.

A recent entry in The New York Times’s blog Well explains that regular sleep habits are important. It advises that you don’t go to bed until you are sleepy, get up at the same time every day, and don’t nap during the day. Studies show that sleep behaviors like the ones discussed in this blog entry are more effective than medications. See more here[12].

What do you do to help yourself sleep? What keeps you awake nights, and what has worked for you? Please let our community know by posting a comment here.

David Spero: David Spero has been a nurse for 32 years and has lived with multiple sclerosis for 25 years. He is author of two books: The Art of Getting Well: Maximizing Health When You Have a Chronic Illness (Hunter House 2002), and Diabetes: Sugar-coated Crisis – Who Gets It, Who Profits, and How to Stop It (New Society 2006). He writes for Diabetes Self-Management and Arthritis Self-Management magazines. He is a project director with New Health Partnerships: Improving care by Engaging Patients, a project of the Institute for Healthcare Improvement.

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